Table IIIThe prevention of MODS in critical illness

Target systemConvincing evidenceControversial or investigational
LungPressure or volume limited ventilation to minimize barotrauma and volutraumaLiquid ventilation, non-physiologic modes of ventilation (high frequency, oscillation)
CardiovascularRestrict transfusion of packed red cells when hemoglobin is > 70Supranormal oxygen delivery; non-crystalloid fluids; SwanGanz catheterization
RenalAvoidance of nephrotoxinsContinuous veno-venous hemofiltration
GastrointestinalStress ulcer prophylaxis with H2 blockers rather than sucralfateGastric tonometry
Enteral nutrition
HematologicDVT prophylaxisAnticoagulant therapies such as anti-thrombin III
ImmunologicSDD (Selective Decontamination of the Digestive Tract)Anti-cytokine and other mediator-targeted therapies (9)
EndocrineCorticosteroids in late sepsis

From: The multiple organ dysfunction syndrome

Cover of Surgical Treatment
Surgical Treatment: Evidence-Based and Problem-Oriented.
Holzheimer RG, Mannick JA, editors.
Munich: Zuckschwerdt; 2001.
Copyright © 2001, W. Zuckschwerdt Verlag GmbH.

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